Effects of the Nottingham Augmented Reality (AR) App for Arthritis Hand Joint Pain

This is a run-in design, feasibility study that uses the enrolled participants as their own control. After consenting to join the study, for the first 30 days, participants will be on their current Standard of Care (SoC). Then, for the next 30 days, the same group of participants will use the Nottingham digital treatment daily. Pre- and Post-SoC and Treatment period measures of opioid use and pain, quality of life measures will be administered and measured. Additionally, for qualifying participants, Pre- and Post-treatment functional Magnetic Resonance Imaging (fMRI) scans will be performed to assess how Nottingham AR therapy affects neuroplastic changes in the supraspinal pain network associated with the therapy sessions.

Inclusion criteria

• Male and female adults ages 21-80
• Clinical diagnosis of chronic hand pain from arthritis or as determined by study physician 3) Hand joint pain at a severity of 4 and above (on a 0 to 10 scale) daily

• Use of prescribed opioids 5) English-speaking, literate, with stable residence 5) Able to operate a smartphone as evidenced by direct observation.

Exclusion criteria

• Major medical illness that might confound effects of pain on function (e.g., advanced cardiac or pulmonary disease)
• Current active alcohol or substance use disorder as evidenced from medical record
• Currently active unstable psychiatric status in previous three months as measured by direct observation, patient self-report, or medical record
• Moderate or severe cognitive impairment as demonstrated by medical diagnosis or clinical observation
• fMRI exclusion only: Any factors that would prevent participation in fMRI